To explore the clinical manifestations, pathological features, diagnosis and treatment of eosinophilic cystitis and its association with deep venous thrombosis(DVT).

The clinical, imaging, pathology and follow-up data of an 54-year-old female with eosinophilic cystitis complicated with iliac vein thrombosis were analyzed retrospectively. MR showed uneven thickening of the right posterior wall of the bladder, a nodular soft tissue protruding into the bladder cavity and dilation of the right upper urinary system. A strip filling defect was detected in the right external and internal iliac vein. The literatures on EC in recent 10 years were summarized.

Cystoscopy showed extensive thickening, edema, congestion, erythema, raised and tumor-like changes of the mucosa on the right wall of the bladder. Bladder biopsies showed a diffuse heavy eosinophilic infiltrate in the bladder wall, involving the mucosa and submucosa, consistent with eosinophilic cystitis. The patient was treated with a 3-month course of antihistamine, steroid and rivaroxaban. Reexamination of MR and cystoscopy showed that the bladder mucosa was smooth and the original right iliac vein thrombus disappeared. There was no dilatation in the bilateral ureters. No symptom and imaging recurrence were observed in 1 year of clinical follow-up.

Eosinophilic cystitis is a rare inflammatory disease of bladder with specific clinical features and may induce DVT through hypercoagulability and platelet activation mediated by allergy or inflammation, but the specific mechanism remains to be investigated.